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M Fanjul, L Pérez, J Cerdá, M Zornoza, R Rojo, I Simal, M A García-Casillas, C Corona, D Peláez, E Molina, A Parente, S Rivas, J M Angulo, E De Tomás
BACKGROUND: Multiple approaches to the treatment of simple and complicated (gangrenous or perforated) appendicitis in children have been promoted. Our goal is to develop a new protocol for these patients that allows shorter hospital stays without increasing complications rates. METHODS: Prospective collected data of patients undergoing appendicitis treated according to the new protocol for a period of 7 months were reviewed. This protocol consists on antibiotic prophylaxis in all cases continued with triple antibiotic regimen in complicated appendicitis...
October 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
Omar E Aly, Douglas H Black, Haroon Rehman, Irfan Ahmed
BACKGROUND: Appendicectomy is a well-established surgical procedure used in the management of acute appendicitis. The operation can be performed with minimally invasive surgery or as an open procedure. A further development in the minimally invasive appendicectomy technique has been the introduction of single incision laparoscopic surgery (SILA). AIM: To ascertain any differences in outcomes from available trials comparing SILA with conventional multi-incision laparoscopic appendicectomy (CLA)...
October 2, 2016: International Journal of Surgery
Thomas P Cundy, Roger Gent, Claire Frauenfelder, Laura Lukic, Rebecca J Linke, Day Way Goh
BACKGROUND: This study appraises the diagnostic quality of ultrasound for acute appendicitis in children and consequently challenges the perception of inferior accuracy and suitability compared to computed tomography (CT). METHODS: Radiologist reports for consecutive "query appendicitis" ultrasound studies were retrieved from a hospital database for the study period 2009-2014. Children who subsequently underwent appendicectomy were identified. Corresponding operative and histopathology findings were evaluated...
September 15, 2016: Journal of Pediatric Surgery
Piriyankan Ananthavarathan, Kamlesh Patel, Catherine Doran, Nigel Suggett
INTRODUCTION: Atraumatic splenic rupture is a rare surgical emergency that is often attributed to neoplastic or infectious causes. Rarely, it has been identified to also occur in the setting of an acute severe sepsis and in cases of pelvic or splenic abscess formation post-appendicectomy. However, to our knowledge, the co-presentation of acute appendiceal abscess and splenic rupture has not been previously described. PRESENTATION OF CASE: We present the case of a 67-year old male with decompensating haemorrhagic shock secondary to atraumatic splenic rupture on a background of an inadequately treated complicated appendicitis originally managed as diverticulitis with antibiotics in the community...
April 13, 2016: International Journal of Surgery Case Reports
Abigail Wheal, Robert Jenkins, Yoshiki Mikami, Nagindra Das, Lynn Hirschowitz
Primary mucinous carcinoma of the fallopian tube is extremely rare. We report the detailed characterization of a mucinous carcinoma arising in the fimbrial end of the fallopian tube in a 74-yr-old woman. The patient presented with recurrent urinary tract infection and urinary tract obstruction secondary to a large right ovarian mass. She had an appendicectomy as an 11 yr old. Serum CA-125 was raised at 239 U/mL. Computed tomographic scans showed bilateral, cystic ovarian tumors but no other intra-abdominal abnormality...
September 22, 2016: International Journal of Gynecological Pathology
Kishore Rajaguru, Daniel Tan Ee Lee
BACKGROUND: The incarceration of an appendix within an inguinal hernia sac is known as Amyand's hernia. Appendicitis in Amyand's hernia accounts for 0.1 % of the cases. An aggressive necrotizing infection of the genitalia and perineum, called Fournier's gangrene, can rapidly progress to sepsis and death. We describe a rare case of Fournier's gangrene complicating Amyand's inguinal hernia which has rarely been reported in the literature. CASE PRESENTATION: This case report describes the presentation and management of a 47-year-old Chinese man who presented with pus discharge from his right inguinoscrotal region and lower abdominal pain with clinical signs of Fournier's gangrene...
September 22, 2016: Journal of Medical Case Reports
R M Heaney, I Reynolds, R S Ryan, I Khan, W Khan, R Waldron, K Barry
BACKGROUND: Financial sustainability is an area of sharp ongoing focus across the broad spectrum of the Irish Health Service. Recent attention has been drawn to the financial implications of non-operative surgical admissions, suggesting that some of these may be unnecessary. AIMS: In this study, we aim to determine the volume of emergency surgical admissions to Mayo University Hospital (MUH), in particular, to identify the scale of non-operative admissions and to assess the wider inherent implications for acute hospital services...
September 8, 2016: Irish Journal of Medical Science
Montserrat Fraga, Nicolas Fournier, Ekaterina Safroneeva, Valérie Pittet, Sébastien Godat, Alex Straumann, Andreas Nydegger, Stephan R Vavricka, Darius Moradpour, Alain M Schoepfer
BACKGROUND AND AIM: Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD). We aimed to assess the prevalence of PSC in the Swiss Inflammatory Bowel Disease Cohort Study, to identify associated risk factors, and to describe the long-term evolution. PATIENTS AND METHODS: Data of patients enrolled into the Swiss Inflammatory Bowel Disease Cohort Study were analyzed. Logistic regression modeling was performed to identify risk factors for PSC...
September 12, 2016: European Journal of Gastroenterology & Hepatology
James Forsyth, Konstantinos Lasithiotakis, Mark Peter
AIM: An appendix mass is the result of a walled-off perforation of the appendix which localises, resulting in a mass and it is encountered in up to 7% of patients presenting with acute appendicitis. However, its management is controversial due to the lack of high level evidence. This review article sets out a rationale diagnostic and therapeutic strategy for the appendix mass based upon up-to-date available evidence. METHODS: A literature review of the investigation and management of appendix mass/complicated appendicitis was undertaken using PubMed, EMBASE and Google Scholar...
September 6, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Nicole N Winter, Glenn D Guest, Michael Bozin, Benjamin N Thomson, G Bruce Mann, Stephanie B M Tan, David A Clark, Jurstine Daruwalla, Vijayaragavan Muralidharan, Neeha Najan, Meron E Pitcher, Karina Vilhelm, Michael R Cox, Steven E Lane, David A Watters
BACKGROUND: Recent data suggest that laparoscopic appendicectomy (LA) in pregnancy is associated with higher rates of foetal loss when compared to open appendicectomy (OA). However, the influence of gestational age and maternal age, both recognized risk factors for foetal loss, was not assessed. METHOD: This was a multicentre retrospective review of all pregnant patients who underwent appendicectomy for suspected appendicitis from 2000 to 2012 across seven hospitals in Australia...
September 6, 2016: ANZ Journal of Surgery
Hamish Shilton, Amin Tanveer, Benjamin Ruimin Poh, Daniel Croagh, Neil Jayasuriya, David Chan
BACKGROUND: A significant proportion of general surgery emergency procedures are conducted after-hours in regional centres. The acute surgical unit (ASU) model reduces the number of after-hours operations performed. We review the burden of emergency surgery in a regional centre and assess what components of the ASU model would benefit regional hospitals. METHODS: Retrospective analysis was performed on data for all emergency cases performed at Latrobe Regional Hospital (LRH) over a 1-year period...
August 31, 2016: ANZ Journal of Surgery
Luiza Moore, Ketan Gajjar, Mercedes Jimenez-Linan, Robin Crawford
OBJECTIVES: The aim of this study was to assess the frequency of appendiceal pathology in women undergoing surgery for mucinous ovarian neoplasm and to evaluate whether appendicectomy is necessary. METHODS: This single-institution retrospective study reviewed prevalence of appendiceal lesions in all patients operated on at our institution from 2002 to 2013 with the final diagnosis of mucinous tumor of the ovary. Clinicopathological data were analyzed. RESULTS: One hundred twenty-three cases were identified...
October 2016: International Journal of Gynecological Cancer
D Chai, R Wijesuriya
Deciduosis (ectopic or extrauterine decidua) is a phenomenon seen in the ovary and cervix and on serosal surfaces of abdominal and pelvic organs. It is thought to be the result of progesterone effects on extrauterine mesenchymal cells during pregnancy. Although deposits are typically asymptomatic and incidentally found in surgically removed tissues on microscopy, deciduosis has also been known to cause pain and intraperitoneal haemorrhage. We sourced all cases of appendiceal deciduosis that have occurred in Sir Charles Gairdner Hospital and Bunbury Hospital between the years 2006 and 2014...
August 23, 2016: Annals of the Royal College of Surgeons of England
E Iaculli, M Agostini, L Biancone, C Fiorani, A Di Vizia, F Montagnese, S Sibio, A Manzelli, M Tesauro, A Rufini, G S Sica
The aim of this study was to determine the perioperative behavior of C-reactive protein (CRP) in Crohn's disease (CD) patients undergoing elective ileo-cecal (IC) resection and to identify association between perioperative CRP levels and endoscopic recurrence at 1 year. Study hypothesis was that perioperative CRP changes are disease specific and could detect subset of patients with more aggressive pathopysiology. Seventy-five patients undergoing IC resection for CD were prospectively enrolled. Serial CRP levels were assessed: preoperative, postoperative day 1 (POD1) and day 5 (POD5)...
2016: Cell Death Discovery
Y Harnoy, Y Bouhnik, N Gault, L Maggiori, L Sulpice, D Cazals-Hatem, K Boudjema, Y Panis, E Ogier-Denis, X Treton
BACKGROUND: Ulcerative colitis (UC) promotes cancer, and can be ameliorated by early appendicectomy for appendicitis. The aim of the study was to explore the effect of appendicectomy on colitis and colonic neoplasia in an animal model of colitis and a cohort of patients with UC. METHODS: Five-week old IL10/Nox1(DKO) mice with nascent colitis and 8-week-old IL10/Nox1(DKO) mice with established colitis underwent appendicectomy (for experimental appendicitis or no appendicitis) or sham laparotomy...
October 2016: British Journal of Surgery
Emma Patricia Stewart-Parker, Mustafa Atta, Sudeendra Doddi
A previously healthy 10-year-old boy presented to the emergency department with central abdominal pain, loose stool and vomiting. He was diagnosed with gastroenteritis, but was well enough to be discharged. The next day he reattended with ongoing diarrhoea and vomiting, with the pain now localised to the right iliac fossa (RIF). Acute appendicitis was suspected, and he was taken for laparoscopic appendicectomy. At surgery, a gangrenous appendix was found, with pus extending from the pelvis up to the liver. The appendix was excised and thorough peritoneal washout performed...
2016: BMJ Case Reports
A A Adejumo, N M Mshelia, Y M Saleh
BACKGROUND: Acute appendicitis is a common cause of acute abdomen and right iliac fossa pain in the study centre with attendant negative appendicectomies. AIM: To study the demographic pattern, aetiology, clinical presentation and management outcome of appendicitis. METHODS: This is a retrospective study carried out on patients, who had appendicectomies between January 2007 and December 2014. A total of two hundred and thirteen (213) cases were operated during the study period...
October 2015: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
Zelalem Assefa
BACKGROUND: Appendiceal mass is one of the complications of acute appendicitis. The management of patients with appendiceal mass is controversial and different treatment options have been suggested. OBJECTIVE: The objective of this study was to assess the results of conservative management of patients with appendiceal mass followed by interval appendicecomy. METHODS: The study was a retrospective analysis of 73 medical records of patients with appendiceal mass who were managed conservatively between March 2007 and February 2014...
April 2016: Ethiopian Medical Journal
R Kumar, R F Bamford, D Kumar, G Singh-Ranger
Appendagitis is an uncommon clinical entity, often not recognised, and mistaken for more serious infective conditions. We describe a proven case of appendagitis which occurred after confirmed appendicitis. We postulate that this condition can coexist with appendicitis and indeed may be the result of coinflammation. This has several implications. Firstly, clinicians must retain an index of suspicion for this condition in a patient with localised abdominal pain which occurs after appendicitis. Secondly, it would be reasonable to suggest careful examination of colocated appendages in a patient with an otherwise normal-appearing appendix...
2016: Case Reports in Surgery
C C van Rossem, M D M Bolmers, M H F Schreinemacher, W A Bemelman, A A W van Geloven, T D Pinkney, A Bhangu
Investigation of suspected appendicitis varies widely across different countries, which creates variation in outcome for patients. Use of imaging drives much of this variation, with concerns over delay of imaging and radiation exposure of computed tomography being balanced against the risks of unnecessary surgery. Two national, prospective snapshot audits (United Kingdom n=3326 and Netherlands n=1934) reported investigation, management and outcome of appendicectomy and can be compared to generate treatment recommendations...
July 25, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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